Effect of Contrast-Enhanced Echocardiograms on the Prognosis of Infective Endocarditis

Objective - Infective endocarditis (IE) is an infectious disease of the cardiac valves where bacteria colonize the valves; typically, via the formation of vegetations. Recent research has shown that the microbubbles in a contrast-enhanced ultrasound (CEUS) examination can move and dislodge bacterial vegetations in vitro. This study investigated whether CEUS resulted in faster resolution of IE in vivo by dislodging the vegetations. Methods - This IRB approved retrospective study reviewed 36 patients who were diagnosed with IE via echocardiography. Data was sourced from patients within the Jefferson University Hospital’s Cardiology EMR system by searching for contrast and vegetation from January 1st, 2013 – January 1st, 2018. Fifteen patients were not given contrast, whereas 21 patients were given contrast via agitated saline (n=16) or an ultrasound contrast agent (n=5). All patients received an echocardiogram after blood cultures confirmed an infection, but before resolution of infection (defined by negative blood cultures). A student’s t-test was used for analyses. Results - The study population was heterogeneous in terms of sex (67.5% male) and race (70% Caucasian, 25% African American, and 5% Asian), with an average age of 51±20 years, and an average BMI of 29.65±7.43 in the contrast group and 27.67±3.16 in the non-contrast group (p=0.37). Following ultrasound, no patients had documented stroke, pulmonary embolism, or systemic blood clot, which physicians could have attributed to a thrombus resulting from dislodging of bacterial vegetation. Overall, blood cultures did not clear faster in patients receiving CEUS compared to those undergoing standard echocardiography, (2.63±2.69 days vs. 1.34 ±1.11 days, p=0.09). CEUS also did not shorten the admission length in patients with IE, (16.9±7.7 days vs. 19.9±12.1 days; p=0.36). Conclusion - Based on this limited sample size, patients who underwent CEUS did not have a different prognosis when compared to patients who received a non-contrast echocardiogram

A symmetry adapted approach to vibrational excitations in atomic clusters

An algebraic method especially suited to describe strongly anharmonic vibrational spectra in molecules may be an appropriate framework to study vibrational spectra of Na$^+_n$ clusters, where nearly flat potential energy surfaces and the appearance of close lying isomers have been reported. As an illustration we describe the model and apply it to the Be$_4$, H$_3^+$, Be$_3$ and Na$_3^+$ clusters.Comment: 8 pages with 2 tables, invited talk at `Atomic Nuclei & Metallic Clusters: Finite Many-Fermion Systems', Prague, Czech Republic, September 1-5, 199

Comment on ``Boson-realization model for the vibrational spectra of tetrahedral molecules''

An algebraic model in terms of a local harmonic boson realization was recently proposed to study molecular vibrational spectra [Zhong-Qi Ma et al., Phys. Rev. A 53, 2173 (1996)]. Because of the local nature of the bosons the model has to deal with spurious degrees of freedom. An approach to eliminate the latter from both the Hamiltonian and the basis was suggested. We show that this procedure does not remove all spurious components from the Hamiltonian and leads to a restricted set of interactions. We then propose a scheme in which the physical Hamiltonian can be systematically constructed up to any order without the need of imposing conditions on its matrix elements. In addition, we show that this scheme corresponds to the harmonic limit of a symmetry adapted algebraic approach based on U(2) algebras.Comment: 9 pages Revtex, submitted February 199

A symmetry-adapted algebraic approach to molecular spectroscopy

We apply a symmetry-adapted algebraic model to the vibrational excitations in D_3h and T_d molecules. A systematic procedure is used to establish the relation between the algebraic and configuration space formulations. In this way we have identified interaction terms that were absent in previous formulations of the vibron model. The inclusion of these new interactions leads to reliable spectroscopic predictions. We illustrate the method for the D_3h triatomic molecules, H_3^+, Be_3 and Na_3, and the T_d molecules, Be_4 and CH_4.Comment: 16 pages with 4 tables, invited talk at `Symmetries in Science IX', August 6-10, 199

A general algebraic model for molecular vibrational spectroscopy

We introduce the Anharmonic Oscillator Symmetry Model to describe vibrational excitations in molecular systems exhibiting high degree of symmetry. A systematic procedure is proposed to establish the relation between the algebraic and configuration space formulations, leading to new interactions in the algebraic model. This approach incorporates the full power of group theoretical techniques and provides reliable spectroscopic predictions. We illustrate the method for the case of ${\cal D}_{3h}$-triatomic molecules.Comment: 35 pages TEX, submitted to Annals of Physics (N.Y.

Radiative capture reaction for 17^{17}Ne formation within a full three-body model

Background: The breakout from the hot Carbon-Nitrogen-Oxigen (CNO) cycles can trigger the rp-process in type I x-ray bursts. In this environment, a competition between $^{15}\text{O}(\alpha,\gamma){^{19}\text{Ne}}$ and the two-proton capture reaction $^{15}\text{O}(2p,\gamma){^{17}\text{Ne}}$ is expected. Purpose: Determine the three-body radiative capture reaction rate for ${^{17}\text{Ne}}$ formation including sequential and direct, resonant and non-resonant contributions on an equal footing. Method: Two different discretization methods have been applied to generate $^{17}$Ne states in a full three-body model: the analytical transformed harmonic oscillator method and the hyperspherical adiabatic expansion method. The binary $p$--$^{15}$O interaction has been adjusted to reproduce the known spectrum of the unbound $^{16}$F nucleus. The dominant $E1$ contributions to the $^{15}\text{O}(2p,\gamma){^{17}\text{Ne}}$ reaction rate have been calculated from the inverse photodissociation process. Results: Three-body calculations provide a reliable description of $^{17}$Ne states. The agreement with the available experimental data on $^{17}$Ne is discussed. It is shown that the $^{15}\text{O}(2p,\gamma){^{17}\text{Ne}}$ reaction rates computed within the two methods agree in a broad range of temperatures. The present calculations are compared with a previous theoretical estimation of the reaction rate. Conclusions: It is found that the full three-body model provides a reaction rate several orders of magnitude larger than the only previous estimation. The implications for the rp-process in type I x-ray bursts should be investigated.Comment: 10 pages, 10 figures. Corrected versio

Evidence of strong dynamic core excitation in 19^{19}C resonant break-up

The resonant break-up of $^{19}$C on protons measured at RIKEN [Phys. Lett. B 660, 320 (2008)] is analyzed in terms of a valence-core model for $^{19}$C including possible core excitations. The analysis of the angular distribution of a prominent peak appearing in the relative-energy spectrum could be well described with this model and is consistent with the previous assignment of $5/2^{+}$ for this state. Inclusion of core-excitation effects are found to be essential to give the correct magnitude of the cross section for this state. By contrast, the calculation assuming an inert $^{18}$C core is found to largely underestimate the data.Comment: 5 pages, 2 figures, to be submitte